High-frequency vesical electrode with insulating tip



' July 15,1930.

M. MOLONY t HIGH FREQUENCY VESICAL ELECTRODE WITH INSULATING TIP 2 Sheets-Sheet 1 Filed Dec. 12, 1929 M. MOLONY July 15, 1 931),

HIGH FREQUENCY VESICAL ELECTRODE WITH INSULATING TIE 2 Shets-Sheet 2 Filed Dec. 12, 1929 i1 F l Nb 4 Patented July 15, 1930 UNHE STATE MARTIN MOLONY, OF SAN FRANCISCO, CALIFORNIA HIGH-FREQUENCY VESICAL ELECTRODE .WITH INSULATING- TIP Application filed December 12, 1929. Serial 1310. 413,619.

This invention relates to improvements in surgical instruments and particularly to improvements in that class known as hi'gh-frequency vesical electrodes. An object of the invention is to provide a simple compact debe hereinafter described.

The present invention is in reality an im-, provement over that described in Patent No. 1,620,828, granted me on March 15, 1927, for High-frequency vesical electrode, and while the improvement is seemingly simple in nature, nevertheless it contributes materially in solving a problem which has long troubled and hindered those who practice in the art to which this invention relates, and i avoids the detrimental'results so often encountered in such practice.

The high frequency electrode of this invention is intended to ;be used primarily in combination with a crystoscope introduced through a suprapublic cystotomy opening, the latter for the purpose of observing and directing the action of the electrode during diathermic fulguration. The electrode of this invention is used trans-urethrally for the surgical treatment of obstructions and de- 7 formities at the neck of the bladder, and for growths in its interior.

More particularly, my invention comprises the placing by suitable means on the extreme end of the active portion of the active electrode. of a tip of insulating material, such as bakelite, other phenol-condensation products, hard rubber, fibre, or the like. The

active part of the electrode is thus positively prevented from coming into electrical contact with the normal heating walls of the organ undergoing treatment, and thus does not act detrimentally thereon. When it is.

considered "that fundamentally, the action of electro-therapeutic implements is to tear and destroy the diseased flesh by means of high-frequency impulses, and that it is necessary at the same time to protect the healthy tissue, which latter is susceptible to, but to a somewhat lesser'degree than the diseasedflesh, the action of the high-frequency currents, the advantages of applicants simple but long-wanted invention are readily obvious. Especially is this so in view of the fact that puncturing of the very thin walls of the organs undergoing treatment, formed as they are of highly specialized tissue, quite often results fatally.

It frequently happens then, that practitioners have refrained from employing electro-therapeutic treatment, where its effect on the diseased flesh obviously would be advantageous, solely because of the very reasonable fear that the organ walls would be reacted. upon detrimentally. By the use of applicants invention, the practitioners can look solely to the cure of the diseased flesh, without danger of possible injury to the healthy tissues.

While it is obvious that my invention may be satisfactorily employed in conjunction with the internal, active electrode of any therapeutic set, one specific form is specifically illustrated, by way of exemplification, in the accompanying drawings, wherein:

Fig. 1 shows the manner of using the improved instrument for removing a growth or an obstructing deformity at the vesical orifice, V

Fig. 2 is a detail showing the instrument destroying an intravesical growth,

Fig. 3 is a view of a complete instrument I employing my improved form of electrode P.

Fig. 4 is a sectional View of the sheath,

Fig. 5 is a view of the electrode partswith the sheath removed and the head and handle portions in section.

Fig. 6 is a. detailed view of the head showing the manner of adjustment, 8 V

Fig. 7 is'an enlarged detailed view showing the construction at the tip or beak,

Fig. 8 is a second detailed view of the tip.

Fig. 9 is a fragmentary sectional view showing a modified form of rod 8, adapted to prevent any tendency of the latter towards turning, while Fig. 10 is a fragmentary front view taken on the line 1()10 of Fig. 9.

In the embodiment of my invention shown in the drawings A is a cylindrical tube of insulating material, preferably formed of bakelite or similar phenol condensation product. This tube or sheath is of an external diameter approximating the minimum. average internal surgical diameter of the duct in which it is to be inserted, for example, the urethra, and of a length between distal end and head B equal to the maximum length of the parts in which it to be inserted. The head B is formed of the same material as the sheath, A, as is also the tubular extension C. These parts are all securely and rigidly secured together as by moulding or otherwise so as to form an integral whole.

The electrode proper preferably comprises a metal tip 1 screwed to a metal member 2. The part 2 may be pivotally connected to each of two long thin metal rods 3 and 4-. Of the rods 3 and .4, the one designated 3 preferably is securely and rigidlyheld in a head D of bakelite or similar insulating material, while the other rod may pass freely through D and, in its turn be secured rigidly to terminal E. Terminal E is preferably also of bakelite or similar substance. The part C on head B fits into the axially arranged socket S on head D, while the pivot point 5 of rod 3 member 2 is sli htly in advance of the pivot point 6 of re 4 in member 2. The outer ends of the rods 3 and 4 may be flattened and are accommodated in a slot 7 in member 2.

By means of the construction first described the tip or beak of the electrode is in axial osition when the parts D and E are slighty separated, but on member E being moved toward D the rod 4 will also be moved axially and will cause the beak 1 to rotate about the relatively stationary point 5.

To assure smooth operation in the relative movement of arts D and E, the member E may be PIOfi ed with an axially arranged projection F which fits into a second axially arranged socket S in head D. The beak or tip is fixed and limited in its various angular positions by means of a set screw 10 screwed through terminal E and bearing at its end against the head D. A pin 11 extending from head D on one side thereof cooperating with a hole in head B revents relative rotation of these parts, w iile a similar pin 12 on the other side of D cooperating with a hole in E likewise performs this function for these two parts.

The radially arranged connector for leading the high frequency current is shown at 20 and consists of an insulating cylinder of bakelite or similar material inserted in head E. Within this cylinder is a metal spring split-clip arrangement 21 connected to rod 4 so that as one side of the source of high frequency current is connected to clip 21 the current will be also connected to the electrode tip 1.

In Fig. 1 there is shown a manner of using the instrument for fulguration of obstructions and deformities at the vesical orifice. Here V is the cystoscope inserted through the suprapublic cystotomy opening. By insertingthe cystoscope through the sinus as shown,

the action of the electrode can be definitely and accurately observed and directed.

The active electrode is connected to one side of a high frequency source of current as indicated at M and the other side of the source is connected to the iiulifierent eicclrode N bearing against the back of the patient.

The foregoing description is all fully set forth in my prior Patent 1,620,628 above referred to. The essential novelty of the present invention resides in the insulating tip 22, which, as perhaps best shown in Fig. 'i', may be secured to the active part 10f the electrode b any suitable means such as by a threaded sliank 23 of the part 1 engaging with and threading into a corresponding recess 24 of the tip 22. The tip may be formed of any suitable insulating material such as bakelite, condensite, other phenol condensation product, rubber, fibre or the like. This construction described is of course, merely by way of exemplification, and may be departed from or varied at will without departing from the essential features of the invention, for instance, by forming or molding the tip on the active part 1.

For instance, in Figs. 9 and 10 the rod 3 is shown as having an ofiset portion 25 adjacent its extremity nearest D, the outermost slot S therein having an oflset portion S for the rece tion of the same, a nut having a bushed ead 26 may be employed to secure the end portion 27 of the rod 3 in the head D. This construction serves the function of resisting any tendency on the part of the rod 3 to turn relative to the head D. Further, it is obvious that the electrode tip may be employed with any type of electrode, and that the invention in its broader aspect is directed to means for protecting the walls of organs undergoing treatment from electrical contact with the .active portion of the electrode. Consequently it is intended that the invention be limited only by the scope of the appended claims.

,What I claim is:

1. An electrode for high frequency current comprisin a rod adapted to be inserted internally o the patient, and having at least a portion of its extent formed of metal, such portion comprising the active part of the electrode, and a tip of insulating material on the innermost end of the electrode, for preventing contact of the active part of the electrode with the wall of the organ undergoing treatment.

2. A versical electrode for use with high frequency currents comprising a rod adapted to be inserted internally of the patient, and

having at least a portion of its extent formed of metal, such portion comprising the active part of the electrode, and a tip of insulating material on the innermost end of the elec trode, for preventing contact of the active part of the electrode with the wall of the organ undergoing treatment.

3. A vesical electrode for high frequency current comprising the combination of a fixed rod of conducting material, a terminal beak pivotally and electrically connected thereto, means for causing movement of said beak, and a tip of insulating material on the end of said beak remote from said rod, for protecting the walls of the organ undergoing treatment from contact with the active part of the beak. r

4. A vesical electrode for high frequency current comprising the combination of a fixed rod, a second rod movable relative thereto, a terminal beak pivotally attached to both of said rods, means for moving the one rod relative to the other to angular-1y swing said beak, and a tip of insulating material on the end of said beak remote from said rods, for protecting the walls of the organ undergoing treatment from contact with the active part of the beak.

5. A vesical electrode for high frequency current comprising the combination of a fixed rod, a second rod axially movable relative thereto, a terminal beak pivotally attached to both of said rods, means for moving the one rod relative to the other to angularly swing said beak, and a tip of insulating material on the end of said beak remote from said rods, for protecting the walls of the organ undergoing treatment from contact With the active part of the beak.

6. A vesical electrode for high frequency current comprising the combination of a fixed rod, a second rodmovable relative thereto, a terminal beak pivotally attached to both of said rods, means for moving the one rod relative to the other to cngularly swing said beak, means to fix the beak in angular position, and a tip of insulating material on the end of said beak remote from said rod, for protecting the walls of the organ undergoing treatment from contact with the active part of the beak.

7 A vesical electrode for high frequency current comprising the combination of a sheath, a rod in the sheath and fiXedtherein, a cautery tip swingably mounted on the rod, a second rod in the sheath movable relatively to the first rod and attached to the tip, means for moving the second rod, and a tip of insulating material on the end of the said cautery tip remote from the said rods, for protecting the healthy walls of the organ undergoing treatment from contact with the active part of the cautery tip.

v8. A vesical electrode for high frequency current comprising the combination of a sheath, a rod in the sheath and fixed therein, a. cautery tip swingably mounted on the rod, a second rod in the sheath movable relatively to the first rod and attached to the tip, means for moving the second rod, means to fix the said cautery. tip inangular position, and a tip of insulating material on the end of said cautery tip remote from said rods, for pro tecting the walls of the organ undergoing treatment from contact with the active part of the said cautery tip.

9. A vesical electrode for high frequency current, comprising an elongated member of insulating material rigid throughout the greater part of its length and having a swing able metallic cautery tip, and a'tipof in sulating-material on the end-of said cautery tip remote from said elongated member, for

orotectin the walls of the or an under oin b b O b treatment from contact with the active part of said cautery tip.

10. A vesical electrode for high frequency current, comprising an elongated member of insulating material rigid throughout the greater part of its length and having a swingable metallic cautery tip, pivotally connected to the member, and a tip of insulating material on the end of said cautery tip, remote from said elongated member, for protecting the Walls of the organ undergoing treatment from contact with the active part of said cautery tip.

11. A vesical electrode for high frequency current, comprising an elongated sheath of insulating material, a metallic rod in the sheath and fixed therein, a cautery tip pivotally connected on the rod, a second rod in the sheath movable relatively to the first rod and pivotally connected to the said cautery tip, means for moving the second rod, means for connecting a source of high frequency current to the first rod, and a tip of insulating material on the end of said cautery tip remote from said rod, for protecting the walls of the organ undergoing treatment from contact with the active part of the said cautery tip.

12. A vesical electrode for high frequency current; comprising an elongated sheath of insulating material; a metallic rod in the sheath and fixed therein; a smooth, tapered, blunt-nose, metallic, cylindrical, cautery tip swingably connected at one side of its rear end to the rod; a longitudinally movable second rod in the sheath having a pivotal connection with said tip at the rear end thereof laterally at a distance from the swingable connection; means for moving said second rod; means for fixing the longitudinal movement of the second rod relative to the first rod and so the angular position of the tip; means for connecting a source of high frequency current to the first rod; and a tip of insulating material threaded on the end of 5 said cautery tip remote from said rods, for protecting the walls of the organ undergoing treatment from contact with the active part i of said cautery ti '13. A vesical e ectrode for high frequency current comprising the combination of a sheath, 9. rod in the sheath and fixed thereto, a eautery tip swingably mounted on the rod, a second rod in the sheath movable relative to the first rod and attached to the tip, a portion of the rod being offset and adapted to engage in an offset recess in the sheath, to prevent turning of the said rod, means for moving the second rod, and a tip of insulating material on the end of the said cautery tip remote from the said rods, for protecting the healthv walls of the organ undergoing treatment from contact with the active part of the cautery tip.

i MARTIN MOLONY. 

